Schizophrenia

Question 1

What do anti -psychotics work on more - positive or negative symptoms?

Answer 1

Positive e.g.
thought disorder
hallucinations
delusions

Usually less effective on negative symptoms e.g.
apathy
social withdrawal

Question 2

What are positive and negative psychotic symptoms?

Answer 2

Positive e.g.
thought disorder
hallucinations
delusions

Negative symptoms e.g.
apathy
social withdrawal

Question 3

How do first-generation antipsychotics work and what does this cause?

Answer 3

Act predominantly by blocking dopamine D2 receptors in the brain. They are not selective so act on all four dopamine pathways in the brain - so can cause lots of side effects, particularly extrapyramidal symptoms and elevated prolactin.

Question 4

The phenothiazine derivatives (1st gen) can be divided into 3 groups. Name some examples of each group and how they are characterised.

Answer 4

Group 1 - chlorpromazine, hydrochloride, levopromazine & promazine hydrochloride
Generally characterised by pronounced sedative effects & moderate antimuscarinic and extrapyramidal side effects.

Group 2 - pericyazine
Generally characterised by moderate sedative effects, but fewer extrapyramidal effects comapred to groups 1 & 3

Group 3 - fluphenazine decanoate, perphenazine, prochlorperazine, trifluoperazine
Fewer sedative and antimuscarinic effects but more prononced extrapyramidal effects than groups 1 & 2